Acute confusional state; Acute brain syndrome DefinitionDelirium is sudden severe confusion due to rapid changes in brain function that can occur with physical or mental illness. CausesDelirium is most often caused by physical or mental illness and is usually temporary and reversible. Many disorders may cause delirium. Often, these disorders do not allow the brain to get oxygen or other substances. They may also cause dangerous chemicals (toxins) to build up in the brain. Delirium is common in the intensive care unit (ICU), especially in older adults. Causes include:
SymptomsDelirium involves a quick change between mental states (for example, from lethargy to agitation and back to lethargy). Symptoms include:
Exams and TestsThe following tests may have abnormal results:
The following tests may also be done:
TreatmentThe goal of treatment is to control or reverse the cause of the symptoms. Treatment depends on the condition causing delirium. The person may need to stay in the hospital for a short time. Stopping or changing medicines that may worsen confusion, or that are no longer needed, may improve mental function. Disorders that contribute to confusion should be treated. These may include:
Treating medical and mental disorders often greatly improves mental function. Medicines may be needed to control aggressive or agitated behaviors. These are usually started at very low dosages and adjusted as needed. Some people with delirium may benefit from hearing aids, glasses, or cataract surgery. Other treatments that may be helpful:
Outlook (Prognosis)Acute conditions that cause delirium may occur with long-term (chronic) disorders that cause dementia. Acute brain syndromes may be reversible by treating the cause. Delirium often lasts about 1 week. It may take several weeks for mental function to return to normal. Full recovery is usually expected, but depends on the underlying cause of the delirium. Possible ComplicationsProblems that may result from delirium include:
When to Contact a Medical ProfessionalContact your health care provider if there is a rapid change in mental status. PreventionTreating the conditions that cause delirium can reduce its risk. In hospitalized people, avoiding or using a low dosage of sedatives, prompt treatment of metabolic disorders and infections, and using reality orientation programs will reduce the risk of delirium in those at high risk. ReferencesInouye SK. Delirium and changes in mental status. In: Goldman L, Cooney K, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 361. Mendez MF, Yerstein O. Delirium. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 4. | |
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Review Date: 12/31/2023 Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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Central nervous sy...
Brain
